When children born with a cleft palate have difficulty breast feeding, most mothers switch to bottles and use either pumped breast milk or formula. But the vast majority of bottles aren’t designed for babies with a cleft palate, and won’t be much help at all.
Good thing there are a number of specially-designed bottles for children with orofacial clefts. In this guide, we’ll cover the most popular types and how to use them.
Feeding Your Baby With A Cleft Palate Bottle
In general, there are two basic categories of bottles for babies with a cleft palate: assisted-delivery and not.
Assisted-delivery bottles are soft and squishy, which allows parents to gently squeeze the reservoir and increase the flow of milk. Other bottles are more rigid, and your baby will use tongue compression to release the milk as needed.
Whichever type works for you and your baby is the best one. Work with a lactation consultant or other member of your orofacial cleft team to find the right feeding strategy.
If you’d like to help control the flow of milk, try an assisted-delivery bottle like the Enfamil cleft palate nurser. Soft and stubby, this bottle can be found in most nurseries. Some mothers like to switch out the nipple for a softer version, because the one that comes with the bottle is kind of hard.
The trick with any assisted-delivery bottle is to find your baby’s rhythm. You should only compress the reservoir while your child is sucking. If your baby pauses to breath, you should stop and wait for her to begin sucking again. You’ll see air bubbles filtering up to the bottle’s end as your child sucks.
Medela Special Needs Bottle
Medela’s Special Needs Bottle is another assisted-delivery choice, but a little more complicated than the Enfamil. Formerly called the Haberman feeder, this bottle is really just a special type of nipple, which looks almost like a syringe, that can attach to any standard bottle.
Follow the manufacturer’s instructions to assemble the bottle. It comes with five separate parts: a valve, disk, nipple, collar and bottle. The one-way valve makes sure that milk fills the nipple.
The Medela’s reservoir is compressible, and marked with three lines of varying length. When aligned with your child’s nose, each line indicates a different strength of flow.
After you’ve assembled the bottle, turn it so the nipple is facing up. Squeeze the tip, flip it upside down, release your hold and milk will begin to fill the nipple. Repeat until the nipple’s reservoir is filled.
Now tickle your baby’s lip and wait for her mouth to open. Place the nipple right on the center of her tongue, with its tip pointing under the unseparated section of her palate. Line up the reservoir’s shortest line with her noise and wait for her to begin to suck. The nipple releases milk when your baby compresses its tip between her tongue and the continuous portion of her palate. In essence, no suction is necessary.
Now try increasing the rate of flow by rotating the nipple in your baby’s mouth. Try lining up the second longest line with your child’s nose to allow for a faster flow. If the flow is too strong and your child begins to cough, just rotate the nipple back down to a shorter line.
Keep experimenting until each feeding is at or under the thirty-minute mark, and she is satisfied after the bottle is empty.
The Pigeon nipple can be attached to any bottle. It doesn’t require sucking, or parent-assistance, because it works differently than most nipples.
At the base is a one-way valve that makes sure the nipple is always filled with milk. The nipple itself has one hard side and one soft side, with a little notch at the base. This air vent should be on top, aligned with your baby’s nose, during feeding. The hard side of the nipple should now be facing up, too.
To fill the nipple, hold the bottle up right and squeeze its tip. Now flip the bottle over, release your squeeze and it should start to fill.
Place the nipple in your baby’s mouth as you normally would, and wait for her to activate the flow by compressing the tip with her tongue.
Sometimes the nipple will collapse in on itself and you’ll need to loosen the collar that holds the one-way valve in place. If the nipple collapses repeatedly, you may find it helpful to enlarge the “Y”-shaped cut at its tip manually with a blade.
How Do I Know That Our Bottle Is Working?
Newborn babies start out slowly, taking in about one ounce at a time, so they’ll want to feed more frequently. Over time, they’ll be able to drink more, reaching an average of two ounces for every pound they weigh. Since the average baby is around eight pounds, they’ll require anywhere from sixteen to twenty ounces of milk every 24 hours to grow.
With the help of your orofacial cleft team, weigh your newborn weekly to make sure she’s on target. And monitor feedings on your own. If it takes longer than 30 minutes for your baby to be satisfied, ask your feeding specialist for suggestions on a new strategy. Any session longer than half an hour requires more effort than your baby should be exerting.
You might have to try multiple nipple styles before finding the one that works best for your baby. Before switching, give your child around two days to adjust to the new system. If it still doesn’t work, you’re ready to move on and try something new.
For some babies, it may be enough to modify a normal nipple. Push the nipple inside-out and use a sharp blade to cut a small “X” shape at the tip. Now fold it right-side-out, and try feeding. If the flow is still too slow, try enlarging the “X,” continuing this process of trial and error until you’ve found the right volume for your baby.